Efficacy of Treatment with Topical Ruxolitinib Cream in Patients with Vitiligo
Archives of Dermatological Research: Published: August 2024
Vitiligo, an autoimmune condition characterized by
depigmented skin patches due to the loss of functional melanocytes, has been
linked to dysregulation in the JAK-STAT signaling pathway, particularly in
IFN-g signaling. The use of JAK inhibitors, such as ruxolitinib cream, a JAK1
and JAK2 inhibitor, presents a promising approach for vitiligo treatment.
This study aims to systematically assess the effectiveness
and safety of ruxolitinib cream in patients with vitiligo.
TAKE-HOME MESSAGE
This systematic review and
meta-analysis involving three randomized controlled trials assessed the
outcomes of using ruxolitinib cream for the treatment of patients with
vitiligo.
Treatment with ruxolitinib cream
resulted in significant improvements in various vitiligo scoring indices
compared with placebo, with greater efficacy at 24 weeks than at 12 weeks.
There was a significant increase in
the risk of any adverse events in the ruxolitinib group compared with the
placebo group; however, there was no significant difference in the risk of
drug-related adverse events or serious adverse events between the two groups.
CONCLUSION
The findings strongly support the efficacy of ruxolitinib therapy
in improving various parameters over time for treating vitiligo.
Although the safety profile of ruxolitinib should be
considered, the risk of drug-related or serious adverse events was comparable
between the ruxolitinib and placebo groups.
Doctors Liked to Read More
Vitiligo, an autoimmune condition characterized by
depigmented skin patches due to the loss of functional melanocytes, has been
linked to dysregulation in the JAK-STAT signaling pathway, particularly in
IFN-g signaling. The use of JAK inhibitors, such as ruxolitinib cream, a JAK1
and JAK2 inhibitor, presents a promising approach for vitiligo treatment.
This study aims to systematically assess the effectiveness
and safety of ruxolitinib cream in patients with vitiligo. We conducted a
systematic review and meta-analysis following PRISMA guidelines to evaluate the
efficacy and safety of ruxolitinib cream for the treatment of vitiligo.
A comprehensive search of PubMed, Google Scholar, and
Cochrane Library databases for randomized controlled trials (RCTs). Data
selection, screening, extraction, and risk of bias assessment were meticulously
performed. Statistical analysis was conducted using Review Manager Software,
version 5.4, with significant heterogeneity addressed through appropriate
methods.
Our meta-analysis included 3 studies with 830 vitiligo
patients. Significant improvements were observed in F-VASI, T-VASI, F-BSA, and
T-BSA scores, with greater efficacy at 24 weeks compared to 12 weeks [MD
-24.17, 95% CI (-31.78 to -16.56), P < 0.00001], [MD -14.12, 95% CI (-20.54
to -7.70); P < 0.0000], [MD -16.25, 95% CI (-22.20 to -10.31),
P < 0.00001], [MD -9.19, 95% CI (-13.47 to -4.92); P < 0.00001].
Ruxolitinib showed increased risk ratios for F-VASI75,
F-VASI90, and F-VASI50, indicating better outcomes with longer treatment
durations [MD 2.9, 95% CI 1.88-4.49; P < 0.00001], [MD 4.66, 95% CI
2.09-10.39; P = 0.0002], [MD 2.53, 95% CI 1.84-3.46; P < 0.00001].
No significant differences were found in mild and moderate
adverse events, while severe cases favored ruxolitinib. Placebo had a
significant advantage in any adverse events, with no significant difference in
drug-related adverse events. Serious adverse events did not significantly
differ between groups.
The findings strongly support the efficacy of ruxolitinib therapy
in improving various parameters over time for treating vitiligo. However,
thorough consideration of its safety profile, particularly concerning adverse
events and potential side effects, is warranted. Further studies with larger
sample sizes are needed to confirm these conclusions.
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